Source: Autism Parenting Magazine (UK) by Katherine G. Hobbs

Why children might need vitamin and mineral supplements

Children with autism spectrum disorders (ASD) have long been prescribed vitamins, minerals, and natural supplements to help with sleep, gastrointestinal distress, and boost low vitamin levels, all of which are common in children and adults with ASD.

The Centers for Disease Control and Prevention (CDC) states that “Many biomedical interventions call for changes in diet. Such changes include removing certain types of foods from a child’s diet and using vitamin or mineral supplements.” The CDC stresses that while remedies that work for one child may not work for another, dietary changes or supplements are a worthwhile option to explore. (CDC, 2015)

A 2009 study by Allison E. Golnik and Marjorie Ireland that surveyed 539 physicians found that vitamin and mineral supplements were one of the “most widely recommended medical interventions for autism, and are recommended by 49% of physicians for children with autism.” (Adams, 2018)

However, there has recently been an increase in clinical studies assessing the benefits of autism supplements in children that extend beyond their sleep and digestion. Eye contact, behavior, and depression have recently been noted to have improved in some children with autism who take cod liver oil (rich in vitamins D and A).

Beyond the issues specific to autism, most Western diets are deficient in key vitamins and minerals including iron, B vitamins (B6, B12, and folate), antioxidant vitamins A, C, and E, vitamin D, and minerals magnesium and calcium.

Children, both with ASD and neurotypical, require a comprehensive diet filled with vitamins and minerals during this time of growth and brain development. Picky eaters will require closer monitoring of their vitamin and mineral intake to be sure they are receiving all the nutrition necessary.

Your child’s doctor or a registered dietician, along with blood work, will be able to tell you where your child is lacking nutritionally and help you make a plan to fill in the gaps in his/her diet.

Which autism supplements do doctors recommend most often for children with ASD?

A doctor’s first priority when recommending vitamin and mineral supplements is usually to identify gaps in the child’s diet. Your child’s pediatrician might ask you to keep a log of your child’s eating for a week or two so that he/she can get an idea of what your child enjoys and what vitamins and minerals are present in those foods.

It can be helpful to write a list of foods your child dislikes and refuses to eat as well. This list might include textures, food groups, or flavors in addition to specific food items.

It is important to note that while some children may get plenty of vitamins A, E, D, and K, they are fat soluble vitamins, which means that if your child does not eat enough fat, he/she will not be able to absorb these vitamins. A child who eats a vegan or vegetarian diet may be lacking in B12 as it is found only in animal products.

Your child’s pediatrician may try to incorporate lacking vitamins and minerals into your child’s diet before going to a supplement as it is the way our bodies prefer to receive nutrition. However, when this is not possible, your pediatrician may prescribe vitamins in liquid, sublingual, chewable to swallowable pill form.

It is crucial to seek guidance from your child’s pediatrician before starting your child on a supplement regimen and wean your child on to higher doses of supplements. If supplements are suggested, they will be specific to your child’s unique nutrition and body, but some are more commonly recommended in children with ASD than others.

Melatonin for autism

About half of children with ASD struggle with sleep. There are a variety of factors that may contribute to this including anxiety, an irregular circadian rhythm, medication side effects, or hyperactivity to name a few. Melatonin is a supplement that aids in sleep and wake cycle regulation. It is a hormone found naturally in the body and produced in the pineal gland in the brain.

Melatonin can be naturally found in some fish and eggs but is most plentiful in nuts, seeds, and bananas—all of which make excellent evening snacks. However, when foods containing melatonin are limited, and the brain is not producing it correctly, your pediatrician may suggest a supplement. Melatonin is available over the counter is and is most commonly a sublingual (dissolves under the tongue). A specific dosage can be recommended by your doctor and is usually buildable based on your child’s needs.

Probiotics for autism, can they help ease the symptoms?

Gastrointestinal (GI) distress is another common problem many children with ASD face. According to the CDC, children with ASD are three and a half times more likely to experience GI complications than their neurotypical peers. Some researchers believe there is a link from gut bacteria to autism severity, but this is still debated within the medical community, and much of the evidence is anecdotal.

Children who experience frequent, prolonged or chronic GI distress should be evaluated by their pediatrician who may refer them to a gastroenterologist for further testing. The doctor may prescribe a probiotic, specifically a Bacteroides fragilis probiotic. When studied in animals with ASD-like behaviors, it was found to reverse ASD-related behaviors, normalize gut microbiota, and improve gut barrier integrity.

These findings have not been confirmed in humans, but some doctors are prescribing Bacteroides fragilis probiotics and finding it to ease symptoms in children.

Studies show vitamin D reduces manifestations of ASD

A study published in the Journal of Child Psychology and Psychiatry and Allied Disciplines found that children with ASD who supplemented with Vitamin D3 showed improvement in signs and symptoms related to ASD. (Saad, et al., 2018) Amber Tovey, the Program Manager for the Vitamin D Council, sums up the research as follows:

“After four months, vitamin D supplementation significantly improved the core manifestations of ASD, which include irritability, hyperactivity, social withdrawal, stereotypic behavior, and inappropriate speech. The placebo group did not experience any significant improvements.

“Furthermore, children who received vitamin D supplementation experienced increased cognitive awareness, social awareness, and social cognition compared to those who only received the placebo. Vitamin D supplementation significantly decreased repetitive hand movements, random noises, jumping, and restricted interests.” (Tovey, 2018)

Can too much folic acid cause autism?

A 2011 study by C. Mary Bear et al., studied whether too much folic acid in utero (via prenatal supplements) or after birth could cause autism. The study’s results were inconclusive and required further research, but it did note that not enough folic acid is proven to cause nervous tissue damage and therefore it suggested that too much folic acid could potentially cause nervous tissue damage associated with autism. It might be worth it to have your child’s folic acid levels assessed via blood work to be sure he/she is receiving an appropriate dosage.

While further studies were suggested in 2011, there has not been any conclusive evidence yet published.

Vitamin B6 and magnesium to ease autism symptoms

More than a dozen studies have suggested that supplementing vitamin B6 and magnesium in children with autism helps to ease symptoms, but the treatment remains controversial as each child’s body will react differently to varying interventions. The theory is that a child with ASD may show improved behavior once vitamin B6 and magnesium is introduced into the diet.

While several well-controlled studies noted this improvement, the specific improvements were inconsistent and ranged from better eye-contact to increased impulse control and improved social interactions and communication.

Both B6 and magnesium levels should be monitored in children with autism whether they are on a supplement or not as magnesium levels tend to be lower in children with ASD, and it is required for the proper absorption and use of B6 in the body. Both are essential nutrients.

Starting your child on a supplement regimen

As noted above, your first step when exploring autism supplements for your child should always be a pediatrician or a registered dietician. It is crucial to monitor your child’s responses to different supplements as some can interact with other medications, be dangerous at too high of a dose, or simply not work well in your child’s body.

The autism supplements mentioned above are some of the most commonly prescribed ones for children, but others may work well for your child, or the ones above may not be appropriate. A blood test or urine test is the most accurate way to track your child’s vitamin levels and should be performed as often as your child’s doctor recommends to ensure that your child’s supplements are being taken at a therapeutic level.

Your child’s teacher, psychiatrist, psychologist, or occupational therapist will likely benefit from being aware of supplements your child takes to help you note potential changes in your child’s health and behavior.

Dr. Adams, the director of the Autism/Asperger’s Research Program at Arizona State University and President of the Autism Nutrition Research Center shares the following advice for parents who decide to try supplements for their child:

“We recommend that all children and adults with autism consider a 2-3 month trial of a vitamin/mineral supplement designed for individuals with autism that is similar to the one used in our studies. By starting at a low dose, and gradually increasing it, there is minimal risk of adverse effects, and many children and adults are likely to benefit, sometimes substantially.” (Adams, 2018)

Finally, all supplements should be kept out of your child’s reach, just as you would lock away prescriptions, as they can be dangerous or lethal when taken as an overdose.